First-year Medical Curriculum Research Articles

Transmogrifying Anatomy Learning by Kaizen Strategies and Game-Based Education.

The study explores the significance of continuous improvement through Kaizen in the evolving landscape of anatomy education. In this study, our objectives were twofold: 1) to assess the effectiveness of incorporating games in the first-year medical curriculum for reinforcing anatomy knowledge, and 2) to explore whether game-based sessions elicit improved student responses in the learning of anatomy. A total of 100 first-year Bachelor of Medicine and Bachelor of Surgery (MBBS) students at All India Institute of Medical Sciences (AIIMS), Bibinagar, Hyderabad, Telangana, India, were exposed to game-based learning which involved six rounds: acronym mnemonics (Redolent), jigsaw puzzle solving (Dumbfound), Filling gaps in concept maps (Blogging), Connecting images (Kinship), case scenario creation (Penman), and rapid-fire round (Rattling). At the end of the intervention, a test was taken and feedback was obtained from all the participants using a prevalidated questionnaire prepared based on a 5-point Likert scale. Questionnaire responses were subjected to descriptive analysis, and reliability analysis (Cronbach's α) was performed to evaluate the internal consistencies of items. A paired t-test indicated that there was a significantly large difference between before (mean (M) = 17.2, standard deviation (SD) = 9.1) and after (M = 25.9, SD = 8), t(99) = 18.4, p < .001, signifying that the performance of the students was far better with game-based learning approaches than conventional learning. Combining game-based education with Kaizen principles in anatomy education not only prepares students for success in their academic pursuits but also empowers them to navigate the complexities of the ever-evolving healthcare landscape with confidence and proficiency.

Student-Produced Guides alongside First-Year Medical Curriculum: How Peer-Produced Textbooks Change Student Success within Neurology, Cardiopulmonary, and Mixed Systems Courses.

In the United States, medical schools do not have a unified curricular plan that integrates basic sciences and organ-based systems in undergraduate medical education. Instead, institutions rely on independently created lecture material during the first-year medical school curriculum. The drawback to this approach is that no commercial or organizational resources cater to this individualized study plan. This study explored whether students who use student-produced "course guides" experience increased first-year success and improved skills. First-year students at an allopathic medical school completed anonymous surveys about their reference guide usage, time management, organization, stress level, and examination scores. Statistical analysis was performed using Spearman's coefficient of correlation and χ2 tests. All of the tests were performed with a significance level of α = 0.05 and a 95% confidence interval. In total, 186 total students received the survey three times immediately after completing each organ system-based course. A total of n = 49 viable responses were received. One-fourth of the respondents used the guides for ≥3 hours/week. Respondents who used the reference guides reported improved time management, organization, self-confidence, and reduced student stress levels during the first year of medical school, but examination scores were unaffected. Access to student-produced guides increased confidence in self-rated measures of time management skills, organizational ability, and ability to balance medical course expectations. Because of the small sample size, future work will expand the survey population to increase the power to detect differences in these factors.

Digital Dissection with CT Scans Enhances Anatomy Education: First‐year Medical Students’ Perception of Radiology Teaching During the Covid‐19 Pandemic

OBJECTIVEThe aim of this study was to evaluate students’ perceptions of the educational value of online, interactive anatomy radiology laboratories.HYPOTHESISDigital dissection is performed with computed tomography (CT) scans on near life‐size anatomy visualization tables and has been used to teach radiology anatomy at our institution. These sessions were pivoted to online delivery in response to COVID‐19. With the ongoing movement towards technology integration in medical education, if home access to these online laboratories is made available then we hypothesize the perceived learning experience should be preserved.METHODS290 first‐year medical students participated in 10 weekly digital radiology anatomy laboratories, which employed 3D CT scans to emphasize the clinical applications of anatomy. Students reviewed the cases at home prior to the lab on a mobile platform and labs were delivered synchronously via the Zoom platform in a facilitated large‐group format. After the course, a voluntary anonymous online survey was distributed assessing learner satisfaction, task value, emotional achievement, and cognitive load.RESULTSSurvey response rate was 44%. Most participants reported the labs improved their knowledge of anatomy (82%), disease (81%) and clinical decision making (65%), including surgical knowledge (76%). The large group, synchronous learning format was found to be the most effective (68%). Positive emotional achievement was reported (mean 2.98). The extraneous cognitive load of the at‐home mobile technology and lack of time were perceived as the greatest programmatic challenges.CONCLUSIONSynchronous digital dissection labs were perceived as a valuable addition to the first‐year medical curriculum, enhancing learners’ clinical decision making and preparation for medical sub‐specialties. This format of radiology anatomy education can be integrated into blended learning environments to provide students with additional learning opportunities.

A novel, interactive game to improve understanding of respiratory control pathways in first-year medical students.

The physiology of respiration is a challenging subject for many medical students. To assist students, we have developed an active learning game that physically places students within a model outlining the respiratory control pathway. Participants were provided with a vodcast describing the physiology of respiratory control and instructed to view this before the activity. Once in the classroom, groups of students sat at tables marked to represent components of the respiratory control pathway (e.g., apneustic center, diaphragm etc.). Tables were connected with green and red ropes indicating excitatory or inhibitory effects, respectively. Students were presented with various scenarios (e.g., diabetic ketoacidosis) and asked to predict and illustrate the scenario's effect on subsequent steps in the respiratory pathway by waving the appropriate connecting rope. The next table would continue the pattern to simulate the collective physiological adaptation of the respiratory pathway. Thirty first-year medical students participated in this study. Following the activity, 25 out of the 30 participants completed an optional survey. The survey aimed to assess the benefits of adding this activity to our first-year medical curriculum to build a foundational understanding of the physiology of respiration. Responses were overwhelmingly favorable, and participants reported that playing the game significantly improved their perceived understanding of the physiology of respiratory control. All but one of the participants recommended using the activity in future classes. Because the small size of the study group may limit generalizability, future larger scale studies are planned.

Multidisciplinary case-based small group discussions to integrate basic medical sciences with clinical situations

Abstract Objectives Integration of the basic medical sciences with clinical medicine motivates medical students by showing how the fundamental concepts they have learned will come into their future practice. In this context, we created clinical integration sessions (CIS) in our first-year medical curriculum. Methods The instructors of different disciplines wrote the clinical scenarios together. The scenarios were discussed in five sessions with 39 first-year students. The first session’s scenario consisted of four brief “anemia” cases. The next four sessions included a single case, according to the feedback of the students. Students formed groups of 7–8 participants. In the first 2 h, the scenarios were discussed in the groups and questions were answered by the students. In the third hour, the instructors answered the questions together with the students. After the first CIS, written feedback obtained from the students via a survey. Results The survey provided positive feedback on the benefits of active learning within small group discussions, and most of the students thought that their background was sufficient to solve the cases, with some literature search. Conclusion The scenarios, which provide multidisciplinary integration of basic medical sciences and clinical medicine, can be useful educational materials.

The Long and Short of It: Unopposed Basic Science Instruction over Fewer Weeks Improves Student Written Exam Performance in Medical Gross Anatomy

IntroductionMedical schools differ in their curricular strategies for teaching medical gross anatomy (MGA). One fundamental decision in designing a first‐year medical curriculum is whether to teach MGA concurrently with other basic sciences over a longer period of time, or unopposed over a shorter period.MethodsWe assessed the impact of a change in our first‐year medical curriculum on student exam performance by comparing two student cohorts. For the academic year (AY) 2017 cohort (N = 165–169), MGA was taught over 18 weeks, during which time students also took Foundations of Medicine (FOM)‐I (integrated histology and physiology during weeks 1–10) and FOM‐II (biochemistry/basic pharmacology/genetics during weeks 11–18). Based on consistent student feedback regarding the challenge of simultaneously learning biochemistry and head/neck anatomy, the curriculum was changed for the AY2018 cohort (N = 131–135). The first 9 weeks were nearly identical for both cohorts, with FOM‐I taught concurrently, but the last two exam units of MGA were taught unopposed over 4 weeks, followed by the FOM‐II course over another 4 weeks. We compared written exam scores between cohorts to determine if the curricular change significantly affected student performance.ResultsFor the three FOM‐I exams, the AY2018 cohort did not score significantly higher than the AY2017 cohort (dfs = 299–302). For the first two MGA exams, the cohorts did not differ significantly (dfs = 300 and 301, ps &gt; 0.05 for both t‐tests). For the last two MGA exams, the AY2018 cohort performed significantly better than the AY2017 cohort, with mean scores 7.2% higher (df = 299, p &lt; 0.00001) and 9.1% higher (df = 294, p &lt; 0.00001), respectively. Preliminary student course evaluations for MGA (n=110 of 131 students) indicate continued high ratings for the course overall but ambivalence about compressing the last two exam units into only 4 weeks. The most frequent student recommendation was a re‐distribution of course topics in the middle exams. Exam scores and course evaluations for FOM‐II will be similarly compared between the two cohorts when they become available.DiscussionWhether improved MGA exam performance translates into better knowledge retention is as‐yet unknown and difficult to directly assess. However, these preliminary results indicate that students perform significantly better in the last half of the MGA course when it is taught unopposed over a condensed timeline. This could be due to more study time dedicated to MGA or to more effective studying due to reduced task‐switching by students. Whether we would expect similar improvement if the entire course was taught unopposed will be discussed. Additional explanations based on student feedback will be explored.Support or Funding InformationThis study of human subjects was approved by the Texas A&amp;M University Institutional Review Board.This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Evaluation of Process and Satisfaction for Selective Courses in a Medical School

The necessity of embracing selective courses in medical curriculum is increasing due to the expansion of medical knowledge and changes in the health care environment. In contrast to the abundant evidence regarding elective or selective courses during the clinical phase, articles focusing on the preclinical period are relatively scarce. This study aims to explore the development, implementation, and evaluation of newly-adopted selective courses in the first-year medical curriculum in a medical school which recently underwent a major curricular revision. First of all, the Curriculum Committee established goals and operating principles of the courses, and then the committee encouraged all participating professors to attend a related faculty development workshop after finalizing the list of courses. A survey was conducted at the end of each course for evaluation. Of the 36 courses opened in 2016, the overall satisfaction of students was 4.98±1.06 (out of 6) and showed a strong correlation with students’ previous expectations, reasoningand participation-oriented teaching, and outcome of the courses including increased motivation. In the open-ended responses, students and professors described not only intended outcomes such as acquisition of medical knowledge and increased interest in new topics, but also unintended outcomes including positive impression for selective courses and even high satisfaction and rewarding experiences, especially from the teachers’ perspective. Although long-term outcomes remain to be seen, the results of this study show the feasibility and impact of selective courses and will contribute to effective implementation in other medical schools.

Implementation and modification of an anatomy-based integrated curriculum.

Morehouse School of Medicine elected to restructure its first-year medical curriculum by transitioning from a discipline-based to an integrated program. The anatomy course, with regional dissection at its core, served as the backbone for this integration by weaving the content from prior traditional courses into the curriculum around the anatomy topics. There were four primary goals for this restructuring process. Goal 1: develop new integrated courses. Course boundaries were established at locations where logical breaks in anatomy content occurred. Four new courses were created, each containing integrated subject content. Goal 2: establish a curriculum management team. The team consisted of course directors, subject specialists, and a curriculum director. This team worked together to efficiently manage the new curriculum. Goal 3: launch contemporary examination and question banking methods. An electronic system, in which images could be included, was implemented for examinations and quizzes, and for storing and refining questions. Goal 4: ensure equitable distribution of standardized examinations and course grading systems among all courses. Assessments included quizzes, in-course examinations, and National Board of Medical Examiners® (NBME® ) Subject Examinations. A standard plan assigned the contribution of each to the final course grade. Significant improvement was seen on subject examinations. Once the obstacles and challenges of integration were overcome, a robust and efficient education program was developed. The curriculum is expected to continue evolving and improving, while retaining full regional dissection as a core element. Anat Sci Educ 10: 262-275. © 2016 American Association of Anatomists.

Middle Years and Elder Years Team-Based Learning Exercise

Abstract Introduction This exercise is used in a first-year medical curriculum Human Development course. It was developed in 2012, and has been used twice. This team-based learning (TBL) session ut...

Teenage Pregnancy: Team-Based Learning Exercise

Abstract Introduction This team-based learning (TBL) session is used in a first-year medical curriculum and contains a video case presentation of a pregnant teen, her issues and concerns, and her d...

The Long-term Impact of Preclinical Education on Medical Students' Opinions About Radiology

It has been previously shown that integrating radiology teaching into the first year of medical education has an immediate positive effect on medical students' attitudes toward the practice of radiology. The purpose of this study is to determine whether these changes in attitude persist through the clinical years of training and whether preclinical exposure to radiology has a long-term effect on medical students' opinions about radiology and radiologists. The first-year medical curriculum at the University of Pittsburgh School of Medicine was revised between the 2003 and 2004 academic years, with 2.5 hours of additional radiology lectures integrated into the existing preclinical coursework. Additionally, radiology consult sessions were integrated into problem-based learning sessions. An initial survey was administered in the preclinical years of training to assess first-year medical students' attitudes toward radiology before and after the changes to the curriculum. A follow-up survey was administered before graduation to determine whether the changes in attitude revealed in the first survey persisted throughout the remaining years of training, and to assess students' opinions about negative radiologist stereotypes. Students who had undergone the revised curriculum were compared to students who had undergone the traditional curriculum. There were statistically significant differences between the two graduating classes in terms of interest in, and perceptions of, the field of radiology. At graduation, students exposed to the revised preclinical curriculum with a greater exposure to radiology had a greater interest in radiology as a discipline and were more likely to have taken senior electives in radiology. These graduating students were also less likely to agree with negative stereotypes about radiologists. Dedicated medical student teaching from an academic radiologist during the first year of medical school has a positive, long-lasting effect on medical students' attitudes toward radiology. The prevalence of negative stereotypes about radiologists among graduating medical students can be reduced by appropriate teaching of radiology in the preclinical years of medical school.

An anatomical backbone for an integrated first‐year medical curriculum

One current trend in medical education is weaving basic science course content into an integrated curriculum. Related challenges to traditional curricula with separate, department‐based, courses include: curricular governance, examination logistics, lecture and laboratory scheduling, and content distribution among faculty. Having already integrated our anatomy curriculum into a single Human Morphology course with regional dissection at its core, our course recently became the backbone for integrating our entire first‐year medical curriculum. Existing lectures from all courses were rearranged and aligned by topic and supplemented with clinical correlations. Reshuffling and shortening the lectures reduced unnecessary redundancy, reduced hours in class, and reinforced learning by juxtaposing content coverage from multiple perspectives. The logistics of curriculum scheduling, management, and delivery developed over one year in meetings among course directors and other key faculty. The initial outcome maintains course autonomy and course directors. Cross‐departmental faculty meetings continue to provide unprecedented interdepartmental faculty communication regarding teaching, learning, and content. We expect the curriculum to continue evolving toward full integration, retaining full regional dissection as a core element. Supported in part by NIH P03 1B040107 and G12‐RR03034.

Welcome to Histology (Out of Print)

Abstract Introduction This resource is an illustrated hypertext introduction to histology, written for students participating in the first-year medical curriculum at Southern Illinois University Sc...

Application and Usage of Wireless PDAs in a First-Year Medical Curriculum

Personal Digital Assistants (PDAs) have played an increasingly prominent role in the clinical rotation components (i.e., 3rd and 4th years) of many medical programs. However, to date very few medical schools have actively utilized these devices in the first year of medical studies. This paper will focus on the role librarians played in the implementation of wireless PDAs as a learning tool, into a new first-year medical curriculum. Issues discussed will include: the collaborative selection of a “Gold Standard” suite of PDA software; PDA orientation and training for faculty and students; integration of these devices; student PDA usage; and future directions.

Gauging interest in community service: a retrospective review of admission files.

By considering applicants’ humanitarian interests, medical schooladmission committees play a crucial role in helping medical schoolsfulfill their social contract with the public—the selection of com-petent and caring future physicians. Validly assessing such diversequalities, however, remains problematic. Admission committees useundergraduate grade-point average and Medical College AdmissionTest scores as markers of intelligence and aptitude. Applicants’ hu-manitarianism or altruism is less amenable to valid measurement.Usually, such characteristics are expressed through the applicant’sself-reported participation in community service activities. Becausedetails regarding these experiences are often sketchy, the scope anddepth of an applicant’s community service experience remain dif-ficult to ascertain and quantify. Admission committees rely on com-munity service experience information in selecting applicants whomay have altruistic inclinations. Little is known about the predic-tive capacity of this non-academic performance variable as it relatesto behavior in medical school, or future medical practice.This study addresses three questions related to the use of appli-cants’ community service experience for selection and predictionpurposes by an admission committee. First, using key medicalschool admission file materials, can reviewers reliably assess appli-cants’ experiences with, and orientation toward, community ser-vice? Second, do reviewers use specific aspects of community serviceto determine their overall assessments of community service in-volvement? Third, can these assessments predict students’ voluntaryparticipation in a new first-year service–learning elective?

Incorporating discussion of cultural diversity throughout the first-year medical curriculum

Incorporating discussion of cultural diversity throughout the first-year medical curriculum

Personal journal writing in a communication skills course for first-year medical students.

Student journals are used at all levels of education to facilitate academic and personal learning. This paper describes the experience of journal writing from both a student and teacher perspective, in a communication skills course for first-year medical students at Queen's University, Kingston, Ontario, Canada. As one of the requirements of the course, students described their individual reactions to each weekly session in a journal. Teachers responded to each journal entry. Guidelines for journal usage in this course are described. The content of the journals includes topic-related information, comments concerning the student's individual experience of the course, and personal thoughts related to life experiences and becoming a doctor. A summary of evaluations of journal writing by teachers and students is presented. We have observed that journal writing facilitates a personal and reflective perspective to the first-year medical curriculum for both students and teachers. Journal writing appears to initiate and encourage self-awareness by providing a safe place for students to describe their experiences and relationships and to question their own values and beliefs. In the journal, through a mutual sharing of thoughts and feelings, barriers between students and teachers are diminished, leading to enhanced rapport and communication.

A Correlative Study Guide for Neuroanatomy

This small book is a laboratory manual designed to be used as a guide in the study of the central nervous system. The authors recommend that it be used in conjunction with a standard textbook. The text covers most of the material encompassed within the first-year medical curriculum in American medical schools. Some of the chapters have clear line drawings that illustrate particular points, but most have no illustrations. The text is an abbreviated compilation of factual material presented in a succinct manner. The Paris Anatomical Nomenclature has not been used, though it has been accepted by anatomists since 1955. The final section of the book contains a well-prepared atlas of Weigert-stained sections cut transversely. The format of the book is attractive, but its usefulness would seem to depend upon how well this system of organization might be adapted to courses given in different medical schools.